{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T22:27:21Z","timestamp":1648506441401},"reference-count":23,"publisher":"Akademiai Kiado Zrt.","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,3,1]]},"abstract":"<jats:p>Az ut\u00f3bbi \u00e9vtizedben az antikoagul\u00e1ns \u00e9s thrombocytaaggreg\u00e1ci\u00f3-g\u00e1tl\u00f3 k\u00e9sz\u00edtm\u00e9nyek alkalmaz\u00e1sa a k\u00fcl\u00f6nb\u00f6z\u0151 sz\u00edv- \u00e9s \u00e9rrendszeri,\u00a0illetve v\u00e9rk\u00e9pz\u0151 szervi betegs\u00e9gekben sz\u00e9les k\u00f6r\u0171v\u00e9 v\u00e1lt. Ezek a k\u00e9sz\u00edtm\u00e9nyek a thromboemboli\u00e1s esem\u00e9nyek kock\u00e1zat\u00e1nak cs\u00f6kkent\u00e9s\u00e9t szolg\u00e1lj\u00e1k, ugyanakkor n\u00f6velik az em\u00e9szt\u0151rendszeri v\u00e9rz\u00e9s lehet\u0151s\u00e9g\u00e9t. Az endoszk\u00f3pos beavatkoz\u00e1sok sor\u00e1n az antikoagul\u00e1l\u00e1s felf\u00fcggeszt\u00e9se, ez\u00e1ltal a thromboemboli\u00e1s sz\u00f6v\u0151dm\u00e9nyek kialakul\u00e1s\u00e1nak kock\u00e1zata minden esetben gondosan m\u00e9rlegelend\u0151 a kezel\u00e9s folytat\u00e1s\u00e1val j\u00e1r\u00f3 fokozott v\u00e9rz\u00e9s kock\u00e1zat\u00e1val. Ideiglenes antikoagul\u00e1l\u00e1sra szorul\u00f3 betegekn\u00e9l (p\u00e9ld\u00e1ul a m\u00e9lyv\u00e9n\u00e1s thrombosis eseteiben) az elekt\u00edv endoszk\u00f3pos beavatkoz\u00e1sok k\u00e9s\u0151bbi id\u0151pontra halasztand\u00f3k. Kis v\u00e9rz\u00e9si kock\u00e1zat\u00fa endoszk\u00f3pos vizsg\u00e1latok el\u0151tt (p\u00e9ld\u00e1ul diagnosztikus vizsg\u00e1latok biopszi\u00e1val) nem sz\u00fcks\u00e9ges az antikoagul\u00e1ns kezel\u00e9s m\u00f3dos\u00edt\u00e1sa vagy felf\u00fcggeszt\u00e9se. Fokozott v\u00e9rz\u00e9si kock\u00e1zattal j\u00e1r\u00f3 beavatkoz\u00e1sok eseteiben (mint p\u00e9ld\u00e1ul a polypectomia \u00e9s a sphincterotomia) egy\u00e9ni meg\u00edt\u00e9l\u00e9s sz\u00fcks\u00e9ges; az or\u00e1lis antikoagul\u00e1ns kezel\u00e9s felf\u00fcggeszt\u00e9se javasolt \u00e1thidal\u00f3 heparinnal vagy a n\u00e9lk\u00fcl (a thromboemboli\u00e1s kock\u00e1zat f\u00fcggv\u00e9ny\u00e9ben). A thrombocytaaggreg\u00e1ci\u00f3-g\u00e1tl\u00f3 k\u00e9sz\u00edtm\u00e9nyek (aszpirin, clopidogrel, ticlopidin) szint\u00e9n fokozhatj\u00e1k az em\u00e9szt\u0151rendszeri endoszk\u00f3pos beavatkoz\u00e1sokkal j\u00e1r\u00f3 v\u00e9rz\u00e9s kock\u00e1zat\u00e1t. Fels\u0151 p\u00e1nendoszk\u00f3pia el\u0151tt nem sz\u00fcks\u00e9ges a kezel\u00e9s felf\u00fcggeszt\u00e9se. Egy\u00e9b vizsg\u00e1latok el\u0151tt 4\u20137 nappal (a sz\u00edv- \u00e9s \u00e9rrendszeri kock\u00e1zat f\u00fcggv\u00e9ny\u00e9ben) megszak\u00edthat\u00f3 a kezel\u00e9s. Ha az aszpirint els\u0151dleges megel\u0151z\u00e9sre alkalmaztuk, polypectomia ut\u00e1n 14 nappal, sphincterotomi\u00e1t k\u00f6vet\u0151en 10 nappal \u00e1ll\u00edthat\u00f3 vissza. A m\u00e1sodlagos megel\u0151z\u00e9s eseteiben a beavatkoz\u00e1st k\u00f6vet\u0151en egy h\u00e9ttel folytatand\u00f3 az aszpirin adagol\u00e1sa.<\/jats:p>","DOI":"10.1556\/oh.2009.28554","type":"journal-article","created":{"date-parts":[[2009,3,11]],"date-time":"2009-03-11T01:21:10Z","timestamp":1236734470000},"page":"541-548","source":"Crossref","is-referenced-by-count":1,"title":["Anticoagulation and antiplatelet therapy, and gastrointestinal endoscopy"],"prefix":"10.1556","volume":"150","author":[{"given":"Hajnal","family":"Sz\u00e9kely","sequence":"first","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar II. Belgy\u00f3gy\u00e1szati Klinika Budapest Szentkir\u00e1lyi u. 46. 1088"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsolt","family":"Tulassay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.gie.2007.11.037","volume":"67","year":"2008","journal-title":"Gastrointest. Endosc."},{"key":"atypb2","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/CRD.0b013e318158d6dd","volume":"16","year":"2008","journal-title":"Cardiol. Rev."},{"key":"atypb3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1038\/ncpgasthep0387","volume":"3","year":"2006","journal-title":"Nat. Clin. Pract. Gastroenterol. 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